Progesterone levels and miscarriage

I am currently studying TCM and acupuncture for people and for horses and I work in a reproductive Veterinary Clinic.

The question I have is regarding low progesterone levels during pregnancy.

What would be the main considerations to take into account when dealing with low progesterone levels which are leading to early abortion in horses? At the moment treatment with Altrenogest etc is the main way I know to increase progesterone levels to maintain pregnancies. Giving this as a weekly injeciton or as an oral dose daily generally will help a mare to hold her pregnancy till the uterus takes over with the progesterone production.

However, I have a mare that habitually produces twins (double ovulation – however mares cannot carry to term twins, so one of the twins is usually aborted at the 14 day pregnancy scan), evident on the early pregnancy scan. She is still pregnant at 16 days, and 18 days, but is failing to carry the pregnancy passed the 28 day test. Her last ‘normal’ pregnancy was lost at the 7 month stage, it was thought at the time it was due to the hariy caterpillar epidemic. What generally happens is the mare ingests some of the tiny hairs that are on the caterpillars’ back which in turn introduces bacteria into the body. This bacteria gets into the uterus and causes placentitis, which leads to late term abortion.

She has carried one foal full time, born alive and very healthy!

She is coming home today, and is ready to ‘serve’ (no fluid, two large follicles etc). What can I do at this early stage to help her carry a pregnancy through to term? I would like to know what I could work through in a diagnosis checklist, to help her body cope with the stress of pregnancy, balance her hormones and have them work as they should. Will there still be a need to give her progesterone orally or injection, if I start working on her with acupuncture etc?

I would really like to have her carry a foal to term and deliver it live. She is a lovely girl and I would like ultimately what is best for her. She was a great Mum.